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Ruth Cohn
   
Too Much of Nothing: Spotlight on Neglect

"Now, too much of nothing
can make a man feel ill at ease
One man's temper might rise
while another man's temper might freeze

In the day of confession,
we cannot mock a soul

Oh, when there's too much of nothing
no one has control…
Too much of nothing
can make a man abuse a king

He can walk the streets and boast like most
but he wouldn't know a thing

Now, it's all been done before, it's all been written in the book

But when there's too much of nothing,
nobody should look…
Too much of nothing
can turn a man into a liar

It can cause one man to sleep on nails
and another man to eat fire

Ev'rybody's doin' somethin'
I heard it in a dream

But when there's too much of nothin' it just makes a fella mean
Say hello to Valerie. Say hello to Marion. Send them all my salary. On the waters of oblivion."
Bob Dylan1

When I was a teenager, my first boyfriend Ted, was a serious photographer. I used to love to keep him company in the darkroom, in the rosy glow of the safe light watching the then complicated process of film developing. Sinking the eight by ten sheets in the tray of fowl smelling chemical he would shake it back and forth as slowly beneath the waves of the fluid an image would emerge. First blurry, it would gradually sharpen into focus until he determined the resolution was right, and would dunk it into the neighboring tray of fixer. For about 15 years I have been observing the shape shifting dynamics of psychological neglect in a similar way. Without the benefit of precise theory and formal research I am not even close to approaching the fixer vat. Rather this article offers the soft outlines of a profile of the “child of neglect” as it is evolving in my thinking. My hope is that you will join me in taking notice of a population that has too long been silent, invisible and ignored. What follows is the rough outlines of a developing theory and practice, including dips into the various vats that have served as input, influence and impetus for investigation. Although I have much nascent thought and practice regarding treatment, that will have to wait for a future article.

An Emerging Profile "He Wouldn't Know a Thing"

The "child of neglect" first came to my attention by a side route. Long specializing in work with survivors of childhood trauma, I began to see them in couple's therapy, and I observed repeating patterns in the partners the traumatized seemed to bring. Invariably these partners were experts of the designated traumatized person's story, and mysteriously seemed to have no story of their own. Queried about their own past, they would respond, "Nothing happened to me!" What slowly began to take form was a vacuous wasteland of missing experiences. Precisely nothing had happened to them, although myriad developmental experiences and parental interactions would be required for a populated, lively and well-rounded childhood. Although they might acknowledge having been unseen, unknown or bored they are hard pressed to locate anything untoward in their histories, and often have very little memory or interpersonal memory at all.

They may however, be exquisitely focused and meticulously tracking all manner of details of the "other," whomever that happens to be, often a self styled or actual professional psychotherapist or analyst. They may have no idea of what they themselves are feeling (and they often don't), but possess an elaborate theory about your inner world, emotion or motivation.

The Interpersonal World "Makes a Fella Mean"

Often these children of neglect have an appealing enough personality, but because they keep others at arm's (at least) length, they may appear aloof, diffident or cool. Because so much of their lives were spent in solitude they may appear to others to be self-concerned and unthinking about others which is often true. "Out of sight, out of mind" is an attachment survival strategy beginning in earliest childhood, well outside of awareness. They may think of themselves as thoughtful, not realizing that there may in fact be other subjectivities in the world and other ways of doing things beside their own. They may be baffled as to why their partners see them as rigid or controlling when they see themselves as being very rational and effective, generous and kind.

Not far under the surface there may be great anger, resentment, bitterness and cynicism. Again this is often far from accessible, highly ego distonic and disowned, and a therapy challenge to bring to light. It may also, however, be glaringly evident. A fascinating read is the recent autobiography of Rolling Stone Keith Richards,2 caricature of rebellion, rage and irreverence. His life is an illuminating illustration of the neglect profile, also highlighting the associated brilliance; endless efforts to populate the desolation with stimulation, thrills or escapism; and the typical overlay of concurrent significant trauma as well.

"No One Has Control" Three P's

Three signature character traits distinguish these individuals in relationship. I call them the Three P’s: Passivity, Procrastination and Paralysis. Although they are definitely prone to anxiety, their tendency under stress is to freeze or collapse. A fourth P in the interpersonal matrix is Powerlessness. In relationship a typical and deeply resigned refrain is “I don’t know what to do!” Or “There is nothing I can do,” and the conviction about that is profound.

"Send Them All My Salary" Disavowing Interpersonal Need

The interpersonal world of these folks is marked by a rigid self-reliance, they adamantly do not need other people. Unaware, they may gravitate toward a political or spiritual perspective that re-enforces this or has them in self-sacrificing, care-providing or otherwise non-reciprocal relationship, or they may be remarkably autonomous or socially isolated. They may not even notice how reflexively they decline or reject any offer, devalue or “don’t want” what is given. It is typically not needed, or the “wrong thing.” Solitude or a world inhabited by the inanimate, non-human or impersonal (i.e. global or macro) animate is a more interesting, more comfortable or safer place to reside.

"Sleeping on Nails" The Conundrum of Sex

Although one can strive to create an airtight existence free of human dependency, a dilemma is presented by sex. Although with sex, it is indeed possible to "do it all oneself" without the benefit of another, solitary sex is not the same. So how do children of neglect resolve this? There are a number of variations. They may replicate their barren and wanting childhoods, by partnering with a sexually traumatized person unable or unprepared to gratify them, and have a sex life consisting of hunger, complaint, masturbation and preoccupation with the other's deficiency. One of my clients was 72 when I met him. He had spent years dragging his sexually traumatized partner to some of the most renowned sex therapists in the country. He knew her story like a book. It was only in therapy in his 70's that he began to discover his own. Finally working with his partner they began to have a reciprocal and ultimately even satisfying sex life.

Other neglect survivors resolve the conundrum through the use of pornography or professionals. With a professional, one need merely put the money on the bed stand and the danger of interpersonal need is handled. The distance is in place and it is safe to desire, to state clearly what is desired and even to be adequately satisfied. Sex may be lonely, alienated and shameful, but the problem of gratification is, thankfully, apparently solved, even if it creates secrecy or havoc in relationship. Similarly, pornography and alienated infidelity may be the "chosen" solutions. One can speculate about the Eliot Spitzers that leave us all scratching our heads and wondering "Why?" He seemed to have it all in place so why pursue pricey professionals?

Discovering in therapy that there may in fact be a place for their own needs and feelings in a live partnership that involves a sexual give and take may be a terrifying and ultimately transformative revelation. One client, a brilliant and highly successful businessman in his fifties had recently left his second long and sexless marriage. After thirty plus marital years of masturbation and what he described as compulsive pornography use, he was determined to have the sexual freedom that he had missed in adolescence and the sexual satisfaction he had longed for all his life. With high priced escorts, dominatrixes and non-commital encounters procured through casual sex internet sites, he let himself go, adamant that he would never marry again and that monogamy was not for him. He lived out this conviction even after meeting a partner whom he truly liked and who was truly available for sex, making his intentions very clear to her. He lived with her, and by agreement continued seeing professionals.

In therapy this client plumbed his history and began to piece together a desolate story. His father, a military man, was gone about 300 days out of the year beginning when my client was barely months old. His mother managed the burdens of household and parenting all herself, with both her son and then 11 months later his sister. He remembers years of time alone in his room reading, pondering profound existential questions and seeing little use for other people. Discovering sexuality had made him feel alive, if frustrated, and provided a first interpersonal impetus of sorts. Slowly in his fifties he began to develop a deep attachment to a partner truly committed to pleasing him both emotionally and sexually, but still adamantly held on to his convictions about "open relationship." Through in-depth therapy both individually and in couple's work with her he was amazed as he found himself wanting to marry her and even live a monogamous married life. It only came through the discovery of his own desolate story, and developing trust in his partner.

This is, due to the constraints of space, a hazy sketch of the neglect profile. Perhaps to continue the photographic metaphor, it is something of a "negative," highlighting the dark and hidden, even unsavory attributes of a population whom at first glance appears only attractive, successful, unscarred, uncomplicated and not in need of helpers like us. Rudimentary and incomplete as it is, perhaps this rough outline reminds you of someone you know.

"It's All Been Written in the Book" Assistance From Theory and Research

A number of important bodies of literature inform my developing thinking about this population. I am most interested in developing a deepening conversation about these and other theoretical and research wellsprings, and suggestions for more. Regrettably there is space here only to name these sources.

To me one of the most valuable of theoretical constructs is Attachment Theory3 and research. The Avoidant Attachment style provides a potent, preliminary template for the early experience of neglect, where the child is left far too much alone from earliest infancy. These babies may soon learn it is pointless to cry, because their cries echo into emptiness. They withdraw into self-containment and self reliance, although vicissitudes of attachment continue to elicit bodily responses of anxiety and depression. In the interpersonal world they lack initiative, follow-through, persistence and faith in another. They are prone to freeze and collapse, and they do not speak up.

Allan Schore and Daniel Siegel, in the groundbreaking work of interpersonal neurobiology,4 provide convincing and often heartbreaking data reflecting that the infant brain develops in resonance. For the first months and years of life, interplay between the infant's and the primary caregiver's right hemispheres, enable the emergence of essential functions and even structure. In effect, the parent's frontal lobes stand in for the infant's nascent ones for a time, as later the therapist's may be called upon to do. What becomes of the child whose brain resonates into a lonely vacuum too much of the time?

The field of Body Psychotherapy,5 beginning with Wilhelm Reich's Character Analysis offers Character Theory, a typology or alternative to traditional diagnostics. In that system the Oral or Self Reliant character typifies some characteristics of what I am calling the neglect profile. The most brilliant exposition I know of this protocol, is in the work of Stephen Johnson, most notably Characterological Transformation, the Hard Work Miracle.6 Johnson proposes that the ultimate therapeutic task of the Oral is to "get a voice, and get a spine," in the interpersonal, which although they may balk initially to hear it, resonates deeply with many of these clients.

The neurofeedback literature7 offers an illuminating account of the brain of the ADD and ADHD child, whose prefrontal cortex lacks stimulation and chronically under-fires. Like the experience of falling asleep at the wheel where we open the car windows, turn up the radio and seek stimulation of some sort to keep the heavy, hypnotic blanketing from taking over, the ADD or ADHD sufferer endlessly seeks stimulation to ward off the deadening of the sluggish brain. This is why the stimulant drugs are such a godsend to these individuals. Might it be the absence of resonance with another brain that originally spawned the low brain frequencies in the frontal lobes?

Valliant pioneers and researchers working to advance Developmental Trauma Disorder,8 a new diagnostic category for the upcoming revision of the DSM, are diligently studying children who fail to qualify for the diagnosis of PTSD, which effectively addresses the symptom constellation of adult war veterans. Classifying the experiences and missing experiences of these children will contribute to the body of knowledge about neglect and its consequences, and will create the diagnostic possibility for these children to get much needed help.

What else? How else might we advance the dialog about this neglected and quietly suffering population? I have so much more to say and learn. Perhaps you will join me. I observe that while these clients at first deny any identification with the experience of neglect or the designation, (and admittedly "child of neglect" is an impoverished or imprecise descriptor) those who do fit the description are often heartened and relieved that at last someone sees and takes an interest in them. Their partners definitely are!

Writing this got me thinking a lot about Ted. What a difficult relationship that was! His parents old world, working class Chinese immigrants left him alone a lot from his early infancy while they worked hard to run their flower business; all those years he spent in the dark by himself. I wonder what became of him.

The human brain, body, heart and soul are designed, wired and hell bent on connection. Without it, Dylan is spot on. "No one has control." We strive to fill the emptiness, with buffed up caricatures of ourselves, with artifice, with escape, numbing or with impassioned intention we manufacture something, be it destructive or creative to which we can resonate.

"There’s something primordial about the way we react to pulses without even knowing it.  We exist on a rhythm of 72 beats a minute.  The train, apart from getting them from the Delta to Detroit, became very important to blues players because of the rhythm of the machine, the rhythm of the tracks and then you cross onto another track, the beat moves.  It echoes something in the human body.  So then when you have machinery involved like trains and drones, all of that is still built in as music inside us.  The human body will feel rhythms even when there’s not one.  Listen to “Mystery Train” by Elvis Presley. One of the great rock and roll tracks of all time.  Not a drum on it.  It’s  just a suggestion, because the body will provide the rhythm.  Rhythm really only has to be suggested…"
Keith Richards9

References

1. Dylan, Bob. Too Much of Nothing For a splendid 1969 rendition b Peter Paul and Mary, see YouTube. www.youtube.com/watch?v=HMv6P23WWWM
2. Richards, Keith, Life. New York. Little Brown Books, 2010.
3. Cassidy, Jude and Shaver, Phillip, Handbook of Attachment. New York. Guilford Press. 2008 (Second Edition.) A favoriteaAttachment theory/research     resource of mine.
4. Schore, Allan, Affect Regulation and the Origin of the Self. Lawrence Erlbaum and Associates. New Jersey. 1994. Siegel, Daniel, The Developing Mind.
    New York. Guilford. 2001
5. Reich, Wilhelm, Character Analysis. New York. Farrar, Straus and Giraux. 1945
6. Johnson, Stephen, Characterological Transformation, the Hard Work Miracle. New York. W.W. Norton. 1985
7. Hill, Robert, Castro, Eduardo, Getting Rid of Ritalin. Charlottesville. Hampton Road Publishing. 2002
8. van der Kolk, Bessel A. MD, Developmental trauma disorder: Towards a rational diagnosis of or children with complex trauma histories.
    Accessible online via Google.
9. Richards, op cit. p. 244

Ruth Cohn, MFT and AASECT Certified Sex Therapist, is in private practice in Oakland, CA. Also certified in EMDR and Sensorimotor Psychotherapy, she specializes in work wih adults with histories of childhood trauma and neglect and their intimate partners and families. She is currently preparing for certification in EEG Neurofeedback. Her book Coming Home to Passion: Restoring Loving Sexuality in Couples with Histories of Childhood Trauma and Neglect is currently in press. She can be reached at cohnruth@aol.com or www.cominghometopassion.com.

© 2010